Top 6 Authorization specialist Jobs in Mansfield, Oh

Payer Notification Specialist - Case Management, PRN
Knox Community Hospital —Mount Vernon, OH
- Every weekend
- Hospital
- Computer literacy
- HIPAA

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Payer Notification Specialist - Case Management, PRN

Knox Community Hospital -
Mount Vernon, OH

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Job Details

Qualifications

Computer operation
Medicare
Phone communication
Computer literacy
Coding for hospital billing
Windows
Patient service
High school diploma or GED
Medicaid health insurance
Medicare regulations
Medicaid regulations
Medicaid
Typing
Medical terminology
Client interaction via phone calls

Full Job Description

Job Specifics

Career Department

Case Management

Status

PRN

Shift

Saturdays and Sundays, 8:00 am - 2:30 pm

Average Weekly Hours

Contact

Employment Specialists

Phone

740.393.9612

[email protected]

Posting Date

Tue, 07/07/2026 - 12:00pm

JOB SUMMARY

Notifies insurance payers of member admission (and observation if required). Secures all necessary hospital admission and observation /authorizations pre-certifications in a timely manner. Reviews and resolves pre-authorization/pre-certification issues. Responsible for notifying appropriate hospital personnel of insurance and benefit updates and changes, upon discovery. Responsible for gathering and submitting all necessary clinical documentation with pre-certification/authorization initially and as directed by insurance payer and Case Management leadership. Adheres to organizational policies and procedures; regulatory/accrediting body requirements and professional practice standards, including Health Insurance Portability and Accountability Act (HIPPA).

PRIMARY JOB RESPONSIBILITIES

Comply with all local, state and federal regulations
Timely submission of patient information
Verifies that all pre-certification and/or authorizations have been obtained and documented in the HIS system
Will update authorization or pre-certification as needed
Assumes responsibility and accountability for individual knowledge, skills, performance and behavior in accordance with hospital, division and department standards of care and policies and procedures
Utilizes measures to promote and maintain patient, visitor and personnel safety
Maintains patient, employee, physician and organization confidentiality; respects the rights, privacy and property of others
Supports the mission, values and vision of the organization

ADDITIONAL RESPONSIBILITIES

Assists in the orientation and training of new personnel
Demonstrates knowledge of disaster/emergency procedures and responds appropriately
Maintain effective communication with all internal and external customers providing outstanding quality of service
Perform tasks that are supportive in nature to the essential functions of the job
Participate in staff meetings, educational programs, committees, QI activities and mandatory in-services
Demonstrate initiative in personal/professional development
Presents a professional image
Assist with costs through the judicious use of human and material resources
Other duties as assigned

Requirements Include

EDUCATION AND WORK EXPERIENCE

High School Diploma
Medical terminology, ICD10 and CPT coding skills required.
Knowledge of third party payer processes preferred and compliance regulations processes
Knowledge of Medicare and Medicaid payers
3-5 years healthcare experience required
Experience with insurance authorizations preferred

KNOWLEDGE AND SKILLS

Must be able to problem-solve multi-task and work independently
Must have outstanding customer service and telephone communication skills
Must be able to adjust to change
Must be PC literate with skills in windows, email and internet navigation
Must be able to type
Must be able to perform professionally during high stress and high patient volume times

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authorization specialist jobs in mansfield, oh

Payer Notification Specialist - Case Management, PRN

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